精准麻醉策略对全麻下老年患者髋关节置换术后认知功能的影响

Effect of Precise Anesthesia Strategy on Cognitive Function after Hip Arthroplasty in Elderly Patients under General Anesthesia

目的:探究精准麻醉策略对全麻下老年患者髋关节置换术后认知功能的影响。方法:选取2018年8月-2019年8月于本院进行全麻下髋关节置换术治疗的老年患者72例。按照随机数字表法分为观察组和对照组,各36例。观察组实施精准麻醉策略治疗,对照组实施常规麻醉治疗。比较两组术中及术后恢复情况,血清S100β蛋白和神经元特异性烯醇化酶(NSE)浓度以及简易智能精神状态检查量表(MMSE)评分的情况。结果:两组术中出血量、手术时间比较,差异均无统计学意义(P>0.05);观察组拔除气管导管或喉罩时间、苏醒室滞留时间均显著短于对照组,差异均有统计学意义(P<0.05)。T1、T2、T3时,两组NSE、S100β蛋白浓度均高于T0,差异均有统计学意义(P<0.05)。T1、T2、T3时,观察组NSE浓度均低于对照组,差异均有统计学意义(P<0.05)。T1、T2时,观察组血清S100β蛋白低于对照组,差异均有统计学意义(P<0.05)。T5时,两组MMSE评分均较T0时显著降低,且观察组MMSE评分显著高于对照组,差异均有统计学意义(P<0.05)。结论:针对全麻下实施髋关节置换术的老年患者,采用精准麻醉策略治疗,取得极佳的麻醉效果,明显改善患者的认知功能障碍情况,具有临床应用价值。

Objective:To explore the effect of precision anesthesia strategy on cognitive function of elderly patients after hip replacement under general anesthesia.Method:Seventy-two elderly patients who underwent hip arthroplasty under general anesthesia treated in our hospital from August 2018 to August 2019 were selected.They were divided into observation group and control group according to the random number table method,36 cases in each group.The observation group was treated with precision anesthesia strategy,the control group received conventional anesthesia.Intraoperative and postoperative recovery,serum S100βprotein,neuron-specific enolase(NSE)concentration,and simple intelligence mental State Examination(MMSE)score were compared between the two groups.Result:There were no significant differences in intraoperative blood loss and operative time between the two groups(P>0.05).The removal time of tracheal tube or laryngeal mask,the retention time in the wake room in the observation group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).At T1,T2 and T3,the concentration of NSE and S100βprotein in both two groups were higher than those of T0,the differences were statistically significant(P<0.05).At T1,T2 and T3,the NSE concentration in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At T1 and T2,the serum S100βprotein in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At T5,MMSE scores in both two groups were significantly lower than those at T0,and the MMSE score of the observation group was significantly higher than that of the control group,the differences were statistically significant(P<0.05).Conclusion:For elderly patients after hip joint replacement under general anesthesia,precise anesthesia strategy is adopted to achieve excellent anesthetic effect and significantly improve the cognitive dysfunction of patients,which has clinical application value.